| Doctor Name: | MISS ANDREA ROSE FORTMAN |
| NPI Number: | 1093904674 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC-SLP |
| License Number: | SP-7972 |
| Business Practice Address: | 37 Triangle Park Dr Suite 3702 Cincinnati, OH - 452463411 |
| Business Phone Number: | 5137724039 |
| Business Fax Number: | |
| Mailing Address: | 892 Portlock Dr, COLUMBUS |
| State: | OH |
| Postal Code: | 432289257 |
| Phone Number: | 6145818643 |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2007 |
| NPI Last Update Date: | 10/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP-7972 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |